How much does Medicare pay for CPT 95180?

Medicare allowed an average of $136.44 per service and paid $107.28 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $360.13, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 95180?

Injection for rapid desensitization to allergen. It was billed 5,190 times to 899 Medicare beneficiaries by 45 providers in 2024.

Does 95180 pay differently in an office than a hospital?

Yes. The allowed amount averaged $136.97 in an office setting and $103.19 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 95180 most?

Allergy/ Immunology, with 5,061 services from 43 clinicians. Next are Family Practice, Internal Medicine.

CPT 95180

Injection for rapid desensitization to allergen

$136.44Medicare-allowed amount per service, averaged across 5,190 services

Providers submitted

$360.13

Asking price, not received

Medicare allowed

$136.44

The fee schedule figure

Medicare paid

$107.28

Balance is patient coinsurance

Providers submitted an average of $360.13 for this code and Medicare allowed $136.44 — 2.6× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $107.28 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $136.97
Hospital / facility: $103.19

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 5,109 services were billed in an office setting and 81 in a facility.

Services: 5,190
Beneficiaries: 899
Providers billing it: 45
Total allowed: $708,124

What Medicare pays for CPT 95180

Across 5,190 services billed by 45 providers to 899 beneficiaries, Medicare allowed an average of $136.44 per service. That is 5.8 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 95180

Specialty	Services	Beneficiaries	Avg allowed	Providers
Allergy/ Immunology	5,061	875	$136.96	43
Family Practice	76	12	$103.65	1
Internal Medicine	53	12	$133.94	1

95180 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	1,791	$142.42	$104.99	7
Kentucky	670	$127.00	$106.29	9
Virginia	581	$132.06	$107.87	2
Massachusetts	512	$140.32	$106.66	2
Texas	235	$133.26	$106.18	3
North Carolina	221	$130.77	$107.77	3
Arizona	202	$138.98	$107.64	1
Illinois	127	$138.12	$105.21	1
Oregon	112	$133.53	$104.74	1
Nevada	111	$135.82	$105.61	1
Maryland	106	$157.36	$106.01	5
Florida	102	$132.65	$105.41	2
District of Columbia	90	$145.08	$107.81	1
South Carolina	83	$126.00	$106.74	2
Tennessee	76	$127.39	$108.02	1
West Virginia	76	$103.65	$114.36	1
Indiana	66	$127.89	$107.11	1
Utah	29	$131.01	$108.12	2

Related codes

95165Professional service for preparation and provision of 1 or more antige$13.88
95117Professional service for multiple injections of allergen$11.66
95115Professional service for single injection of allergen$9.48
95144Professional service for preparation and provision of single-dose vial$15.85
95170Professional service for preparation and provision of whole body extra$10.50
95148Professional service for preparation and provision of 4 stinging insec$89.39
95149Professional service for preparation and provision of 5 stinging insec$118.84

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.